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Female viagra is another example of society trying to make women sexually "normal" on men's terms

If we really want to “even the score”, as pro-flibanserin campaigners describe, we should respect each woman’s true desires instead of handing over their “dysfunction” to the forces of a market defined by male expectations.

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A husband walks into a bedroom and hands his wife a glass of water and two aspirins.

“What’s that for?” she asks.

“Your headache.”

“But I don’t have a headache!”

“That’s what I wanted to hear!” he says, and leaps on top of her.

I remember this joke – a rape joke – from some comedy sketch show in the early Eighties. It was one of those things that, as a child, you suspect is not quite right, but hey, what do you know? The adults are laughing. That must mean it’s okay.

Ha! Marital rape might be illegal but what’s a little bit of coercion? After all, she’s got no excuse to say no!

Of course, that’s not how backers of the Even The Score campaign (including Sprout pharmaceuticals, owners of Addyi) would like us to see it. According to them, “it’s time to level the playing field when it comes to the treatment of women’s sexual dysfunction”.

Obviously I’m being flippant. It’s actually nonsense to suggest that women’s “sexual dysfunction” has been neglected, given that women have always been considered the dysfunctional ones. Whether we’ve been wanting sex too much or not enough, we’ve always been expected to fit in with cultural, biological and social standards set by men. There is no norm for women other than that which exists in response to male definitions of what women should be. Hence while Viagra treats a definable, immediate problem (inability to achieve or maintain erection), Addyi is a more ongoing treatment aimed at achieving a state of supposed “normality.” It fixes “dysfunctional” women, giving them the desires they are “supposed” to have.

It’s hardly the first treatment that has sought to do this. A brief trawl through the history of medicine and psychiatry offers an insight into how male experts have sought to control female sexual responsiveness. Nineteenth-century sufferers of hysteria could be treated with clitoridectomies or with vibrators and forced masturbation; it all depended on the views of the therapist (and, of course, the anxious husband).

It is a recent feminist myth that our only battle in terms of sexual autonomy has been to prove that we have desires and that these desires are not shameful. An absence of sexual desire has been equally stigmatised. The frigid woman, the asexual monster, the prude – such cautionary figures are used to police women’s sexuality just as effectively as the slut and the whore.

Patriarchy seeks not to limit female desire as such, but to control women’s sexual choices and availaibility in order to extract emotional, physical and economic labour. In such a context, any independent response on the part of a woman will be the wrong one.

Recently the sociologist Catherine Hakim produced a report in which she argued that the sex trade ought to be decriminalised because, “male demand for sex invariably outstrips female demand”. Hakim’s logic is that, “women’s increasing economic independence allows them to withdraw from sexual markets and relationships that they perceive to offer unfair bargains”.

In other words, privileged women can say "no" to sex to which they previously would have said "yes", hence less privileged women are needed to make up the “deficit”.

Regardless of whether one agrees with Hakim’s conclusions about relative rates of desire, her overall message is simple: male desire is the default and female sexuality is constructed by the market (by which we could mean the sex trade or pharmaceutical companies) to fit around it.

If there is an imbalance, it is seen in terms of a female deficit, not a male surplus. Women’s health and wellbeing – and sense of “being normal” – is a price worth paying in order to preserve the idea of male sexuality as unchanging and dominant.

Medicine and psychiatry are not objective. We need to unpick the distress that comes from being diagnosed “sexually dysfunctional” and ask: whose distress? “Dysfunctional” on whose terms? What is wrong with having no desire to partake in an activity that is not essential to the continuation of one’s own life? If the problem is that one does not feel normal, what’s normal anyway? Do all pleasures that fade require restimulation? (Lately I’ve gone off Coronation Street – does my “soap opera enjoyment dysfunction” now require treatment?)

If one is dealing with unequal desire within an otherwise equal relationship, then there are questions to be asked about who sacrifices what for whom. But few relationships are “otherwise equal”, and the risk of exploitation is high when one starts throwing pink and blue pills into the mix.

Of course, one might argue that Addyi is the wrong solution to a problem that genuinely exists. Perhaps, in a world that respected women’s emotional and bodily autonomy, women would desire and enjoy sex more than they currently do. But that should not be a primary reason for women’s autonomy to be respected. We should be okay with the idea that sexual desire can come and go, and with the idea that a woman who does not want or enjoy sex remains a “normal” woman, not some slut-shaming harpy who is out to destroy sexual pleasure for others.

Even within feminism, there is a widespread distrust of the asexual woman, a belief that her lack of desire is pathological and politically dangerous. Women who oppose pornography, Page Three or the sex trade are suspected of harbouring “phobias”. In such a context, the magic pink pill replaces the “medical” vibrator as a sexual device whose real aim is to induce a form of compliance. Take it away and we are still left with a situation in which women are forced to either disclose their sexual interests or withdraw from debate.

Female sexuality should be neither shameful nor distressing, regardless of the form it takes. Hence I struggle to understand why not wanting sex should even be considered a problem. Sex is one of many things to taste and enjoy. If we really want to “even the score” we should respect each woman’s true desires instead of handing over their “dysfunction” to the forces of the market.